Concurrent presentation of cryptococcal meningoencephalitis and systemic lupus erythematosus

Abstract

Cryptococcal meningitis is a recognized complication of systemic lupus erythematosus (SLE), with high mortality rates, particularly in those treated with immunosuppressive agents. We describe a patient diagnosed simultaneously with cryptococcal meningoencephalitis and SLE and reviewed four similar cases reported in the literature. In our case, profound low CD4 lymphocyte count and low complement levels were observed. The patient was treated with prednisolone, fluconazole, and 5-flucytosine and evinced good clinical improvement. This case suggests that intrinsic immunological abnormality related to SLE predisposed to opportunistic infections.

Cryptococcal meningitis in Chinese patients with systemic lupus erythematosus

“…The immune function of patients with SLE is constitutively impaired as a result of the intrinsic immunological defects associated with the disease [22]. Masami et al [23] indicated that intrinsic immunological abnormality related to SLE predisposed to opportunistic infection. Moreover, several studies demonstrate that humoral immunity may also play a role in cryptococcal infections [24,25].…”

Cerebral Lupus and Cryptococcal Meningitis in a Pregnant Woman

“…Death rates could go up to 50% despite antifungal therapy. 9 It was demonstrated that exposure to corticosteroid 20 mg/d or its equivalent in SLE patients would predispose them to infections due to impaired cellular immunity. 8 According to the Infectious Diseases Society of America, treatment in CM for non-HIV infected, nontransplant patients includes an induction phase with amphotericin B plus flucytosine for at least 4 weeks.…”

Successful Treatment of Cryptococcal Meningitis with Amphotericin B in a Patient with Systemic Lupus Erythmatosus

“…But in these patients, cryptococcal meningitis is the most common cause of CNS infection (5). Thus, cryptococcal meningitis is a recognized complication of SLE, with high mortality rates, particularly in those treated with immunosuppressive agents (6). Cryptococcus neoformans is an environmental saprophyte.…”